Provider Demographics
NPI:1396837639
Name:HUBBARD HILL ESTATES, INC.
Entity Type:Organization
Organization Name:HUBBARD HILL ESTATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PINGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-295-6260
Mailing Address - Street 1:28070 COUNTY ROAD 24
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-9774
Mailing Address - Country:US
Mailing Address - Phone:574-295-6260
Mailing Address - Fax:574-295-5852
Practice Address - Street 1:28070 COUNTY ROAD 24
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-9774
Practice Address - Country:US
Practice Address - Phone:574-295-6260
Practice Address - Fax:574-295-5852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-001131-1314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200823940AMedicaid
IN000000493029OtherANTHEM
IN155754Medicare Oscar/Certification